Cooking the books or promoting good practice?
Plenty of comment in the media yesterday about Kingston Hospital’s attempt to reduce the number of blood cultures taken. The BBC story is here. I don’t think they’ve done anything wrong. If there is evidence of specimens being taken when not clinically indicated then this would be good practice. In addition to increasing the possibility of MRSA contaminated specimens being detected, much valuable laboratory time is wasted in processing specimens that were either not required or were contaminated through poor practice. I would also argue that a blood specimen is collected with a view to treat a patient for a clinical infection. If there is no intention to treat then the performance of an invasive investigation for merely epidemiological purposes isn’t really in the patient’s best interests. Professor Mark Enright (Molecular Epidemiology) indicated on Radio 5 live that he thought this was an attempt to reduce the figures. I cannot agree. Kingston Hospital has reduced MRSA rates over the last couple of years by fostering a sense of personal responsibility for Infection Control in the staff working there. The idea that clinicians would attempt to massage figures by not taking specimens when clinically indicated in a patient with an active infection is unthinkable.
February 7, 2008 at 9:07 pm
Thank you for some common sense! There was no mal-intention in the email sent to staff and it only echoes guidance now made in the DH Saving Lives guide to taking blood cultures. I’m sure many trusts are fed up of having their hard work scuppered by poorly taken cultures – so called ‘contaminated specimens’.
I’d also like to know why Mark Enright thinks he is a valid person to comment on this and other MRSA issues as I don’t think he is a practicing microbiologist or infection control doctor (Please correct me if i’m wrong).
Yours cheesed off from Kingston
February 8, 2008 at 7:33 am
[...] should read Martins take on this issue, it helps to clarify what lies behind the news headline. Click here to view Martins [...]
April 22, 2008 at 10:29 pm
[...] should read Martins take on this issue, it helps to clarify what lies behind the news headline. Click here to view Martins [...]
September 28, 2008 at 2:02 pm
I believe that continuing to have blood culture samples contaminated at rates of 10% must lead to inapproprate care for many patients. The plan of care should determine if the reult would be acted upon. If it is not then I agree questions should be asked as to taking blood cultures in the first place.